Change in medical students' attitudes about primary care during the third year of medical school.

Purpose: This study explores how medical students' attitudes and career interests change over the third year, and it investigates the potential of an attitudinal instrument to predict specialty interest.

Method: A total of 106 students in the classes of 1992-1994 at the Clinical Campus at Binghamton of the State University of New York Health Science Center at Syracuse College of Medicine were surveyed at the beginning and end of their third year about specialty interests and attitudes toward medical care practices. The students were divided into primary care, non-primary-care, and undecided groups based on end-of-year preferences. Statistical methods used were paired t-tests and one-way analysis of variance.

Results: Complete data were collected for 99 (93%) of the students: 23 (23%) in the primary care, 60 (61%) in the non-primary-care, and 16 (16%) in the undecided groups. Beginning-of-the-year differences were found among the groups on only four of 29 attitudinal items (p < .05). By the end of the year, the students in the non-primary-care group had changed on more items than those in the primary care and undecided groups. The students in the primary care and the non-primary-care groups diverged on statements relating to physician roles concerning control and treatment of patients.

Conclusion: The results suggest that as students experience direct patient care, the attitudes of students preferring non-primary-care specialties diverge from those who prefer primary care specialties. Attitudinal changes relate primarily to the control of patient care and the role of specialists.